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Back In The Saddle

WordPress has changed the interface of where you type posts so I hope this goes smoothly. There is no worse feeling than writing something and then losing the entire document. That feeling is 10x worse when you are an intern and trying to write all your notes before rounds and then the computer freezes or the EMR just decides to throw you a new one and you want to crawl in a hole and die.

I feel like returning to work after vacation is like jumping in a really cold pool, but somewhat like a baby who doesn’t know how to swim and you’re thrown in and need to figure it all out ASAP or you will drown.

I started back with clinic yesterday in which I think I saw 8 patients in colpo clinic, most of which actually needed a colposcopy (fancy term for looking at the cervix underneath a microscope and taking biopsies) rather than a pap smear (for surveillance stuff — you get to colpo by having an abnormal pap).

I think I saw about the same number in continuity clinic.

I shoved in lunch at 3 pm in between patients. Note to self: Eggs makes for an excellent in between patient meal. Easy to eat quickly. Satisfying enough so you don’t faint and hold you over until you can get to another meal. Two eggs, toasted English muffin, and salt and pepper. Dream team.

Side note: I’m still waiting on the weight loss that residency should be providing me.

Today I was back on labor. The antepartum list was approximately 6 pages long. However, I was successfully able to diurese the list down and only admitted one today.

Somedays you feel like you did so much [paperwork, menial tasks] and have nothing to show for it. Today was one of those days.

One final thing:

Today I went up to the medicine floor (a world away from L&D…ok just a few floors) to see a patient. Two second year med students and their teaching attending were so sweetly interviewing the patient, trying to obtain her medical history.

I remember the first time taking a history and its really easy to get sidetracked and focus on things like how old the patient was when they got their first pet. You don’t know what questions to ask next or how to progress the interview to get the information you need. Basically, you’re just a person with a not so fancy short white coat (this is the sign that you are student) trying to make small talk with a patient about, say, one of their vital organ systems that has landed them in the hospital.

I got a real kick out of the whole thing.

Mostly, because now the history taking seems so routine and rote and after a while you know the set of questions to ask and the order to go in (most of the time, except when a patient comes with 297 pages of records from an outside hospital with 13 medical problems).

I also got a kick out of watching the medicine residents. Just really taking time to dissect down the differential diagnoses and discuss, you know, if this patient did have acute pancreatitis then….and fluid shifts…and albumin…and eosinophils…and the Ranson score….and Afib and RACE and AFFRIM trials…

I then when back to L&D where I proceeded back to my checkboxes and running around frenetically.

That’s all I have to say about today. I couldn’t sleep last night for reasons unbeknownst to me so I was still awake at midnight last night. When you start your work day before 7 am….no bueno.